J Korean Foot Ankle Soc.  2016 Sep;20(3):100-105. 10.14193/jkfas.2016.20.3.100.

Isolated Syndesmotic Injury

Affiliations
  • 1Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. hyongnyun@naver.com

Abstract

Syndesmotic injury can either be isolated or associated with bony or ligamentous ankle injury. When it is not associated with an ankle fracture, it may not be easy to diagnose, especially when there is no franck diastasis on a plain radiograph. Without proper treatment, syndesmotic injury can lead to chronic pain due to impingement of scar tissues and instability. It may further lead to ankle arthritis. Early diagnosis with appropriate management is a prerequisite to avoid these problems. Herein, we review and discuss the mechanism of injury, classification, diagnosis, and treatment of isolated syndesmotic injury.

Keyword

Ankle; Sports; Syndesmotic injury

MeSH Terms

Ankle
Ankle Fractures
Ankle Injuries*
Arthritis
Chronic Pain
Cicatrix
Classification
Diagnosis
Early Diagnosis
Ligaments
Sports

Figure

  • Figure 1. The mechanism of syndesmotic injury is described. (A) A direct blow down to the leg of a football player external rotates the ankle to give syndesmotic injury. (B) External rotating force is applied to the ankle of an ice hockey player when the player’s foot is planted and the knee internal rotated.

  • Figure 2. Tibiofibular overlap (black arrows) and tibiofibular clear space (white arrows) is measured 1 cm proximal to the tibial planfond. Normal distal tibiofibular joint relationship includes overlap of more than 6 mm and tibiofibular clear space of less than 6 mm.


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